{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:29:11Z","timestamp":1777850951563,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T00:00:00Z","timestamp":1544572800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Fam Nurs"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>In families with hereditary breast\/ovarian cancer, complex disease histories challenge established patterns of family communication and influence decision-making for clinical surveillance, genetic testing, and risk management. An interdisciplinary team examined longitudinal interview data from women with identified BRCA1\/2 mutations to assess interactions within family and social networks about risk information communication and management. We used interpretive description to identify motivation, content, and derived benefit of these interactions. Participants discussed risk information and management strategies with biological and nonbiological network members for multiple purposes: discharging responsibility for risk information dissemination, protecting important relationships, and navigating decision trajectories. Evolving interactions with loved ones balanced long-standing family communication patterns with differing personal preferences for privacy or open sharing, whereas interactions with nonbiological network members expanded participants\u2019 range of choices for sources of risk management information. Ongoing assessment of social networks may help support engagement with risk management by aligning with patient social needs.<\/jats:p>","DOI":"10.1177\/1074840718815844","type":"journal-article","created":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T04:11:27Z","timestamp":1544587887000},"page":"28-53","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Legacies and Relationships: Diverse Social Networks and\n                    <i>BRCA1\/2<\/i>\n                    Risk Management Decisions and Actions"],"prefix":"10.1177","volume":"25","author":[{"given":"Anne L.","family":"Ersig","sequence":"first","affiliation":[{"name":"University of Wisconsin\u2013Madison, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Werner-Lin","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Hoskins","sequence":"additional","affiliation":[{"name":"Lindsey Hoskins & Associates, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Young","sequence":"additional","affiliation":[{"name":"Stanford University, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer T.","family":"Loud","sequence":"additional","affiliation":[{"name":"National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June","family":"Peters","sequence":"additional","affiliation":[{"name":"National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark H.","family":"Greene","sequence":"additional","affiliation":[{"name":"National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,12,12]]},"reference":[{"key":"bibr1-1074840718815844","doi-asserted-by":"crossref","unstructured":"Acheson L. S. (2011). Recording, interpreting, and updating the family history of cancer: Implications for cancer prevention. Journal of the American Medical Association, 306, 208-210. https:\/\/dx.doi.org\/10.1001\/jama.2011.980","DOI":"10.1001\/jama.2011.980"},{"key":"bibr2-1074840718815844","unstructured":"American Nurses Association. (2008). Essentials of genetic and genomic nursing: Competencies, curricula guidelines, and outcome indicators (2nd ed.). Silver Spring, MD: Author. Retrieved from https:\/\/globalresearchnurses.tghn.org\/site_media\/media\/medialibrary\/2016\/05\/geneticscompetency.pdf"},{"key":"bibr3-1074840718815844","unstructured":"American Nurses Association. (2011). Essential genetic and genomic competencies for nurses with graduate degrees. Silver Spring, MD: Author. Retrieved from https:\/\/www.genome.gov\/pages\/health\/healthcareprovidersinfo\/grad_gen_comp.pdf"},{"key":"bibr4-1074840718815844","doi-asserted-by":"crossref","unstructured":"Ashida S., Schafer E. J. (2015). Family health information sharing among older adults: Reaching more family members. Journal of Community Genetics, 6, 17-27. https:\/\/dx.doi.org\/10.1007\/s12687-014-0197-x","DOI":"10.1007\/s12687-014-0197-x"},{"key":"bibr5-1074840718815844","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195083316.003.0007"},{"key":"bibr6-1074840718815844","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780195377903.003.0007"},{"key":"bibr7-1074840718815844","volume-title":"Family therapy in clinical practice","author":"Bowen M.","year":"1978"},{"key":"bibr8-1074840718815844","doi-asserted-by":"crossref","unstructured":"Calzone K. A., Jenkins J., Prows C. A., Masny A. (2011). Establishing the outcome indicators for the\n                      essential nursing competencies and curricula guidelines for genetics and genomics\n                      . Journal of Professional Nursing, 27, 179-191. https:\/\/dx.doi.org\/10.1016\/j.profnurs.2011.01.001","DOI":"10.1016\/j.profnurs.2011.01.001"},{"key":"bibr9-1074840718815844","doi-asserted-by":"crossref","unstructured":"Daly M. B., Pilarski R., Berry M., Buys S. S., Farmer M., Friedman S. Darlow S. (2017). Genetic\/familial high-risk assessment: Breast and ovarian, version 2.2017. Journal of the National Comprehensive Cancer Network, 15, 9-20. https:\/\/dx.doi.org\/10.6004\/jnccn.2017.0003","DOI":"10.6004\/jnccn.2017.0003"},{"key":"bibr10-1074840718815844","doi-asserted-by":"crossref","unstructured":"Dancyger C., Smith J. A., Jacobs C., Wallace M., Michie S. (2010). Comparing family members\u2019 motivations and attitudes towards genetic testing for hereditary breast and ovarian cancer: A qualitative analysis. European Journal of Human Genetics, 18, 1289-1295. http:\/\/dx.doi.org\/10.1038\/ejhg.2010.114","DOI":"10.1038\/ejhg.2010.114"},{"key":"bibr11-1074840718815844","doi-asserted-by":"crossref","unstructured":"Dancyger C., Wiseman M., Jacobs C., Smith J. A., Wallace M., Michie S. (2011). Communicating\n                      BRCA1\/2\n                      genetic test results within the family: A qualitative analysis. Psychology & Health, 26, 1018-1035. https:\/\/dx.doi.org\/10.1080\/08870446.2010.525640","DOI":"10.1080\/08870446.2010.525640"},{"key":"bibr12-1074840718815844","doi-asserted-by":"crossref","unstructured":"DeMarco T. A., McKinnon W. C. (2007). Life after\n                      BRCA1\/2\n                      testing: Family communication and support issues. Breast Disease, 27, 127-136. https:\/\/dx.doi.org\/10.3233\/BD-2007-27108","DOI":"10.3233\/BD-2007-27108"},{"key":"bibr13-1074840718815844","doi-asserted-by":"crossref","unstructured":"Derbez B. (2018). Is there a \u201cright time\u201d for bad news? Kairos in familial communication on hereditary breast and ovarian cancer risk. Social Science & Medicine, 202, 13-19. https:\/\/dx.doi.org\/10.1016\/j.socscimed.2018.02.022","DOI":"10.1016\/j.socscimed.2018.02.022"},{"key":"bibr14-1074840718815844","doi-asserted-by":"crossref","unstructured":"DudokdeWit A., Tibben A., Frets P., Meijers-Heijboer E., Devilee P., Klijn J. Niermeijer M. (1997). BRCA1 in the family: A case description of the psychological implications. American Journal of Medical Genetics, 71, 63-71. https:\/\/dx.doi.org\/10.1002\/(SICI)1096-8628(19970711)71:1<63:AID-AJMG12>3.0.CO;2-T","DOI":"10.1002\/(SICI)1096-8628(19970711)71:1<63::AID-AJMG12>3.0.CO;2-T"},{"key":"bibr15-1074840718815844","doi-asserted-by":"crossref","unstructured":"Ersig A. L., Williams J. K., Hadley D. W., Koehly L. M. (2009). Communication, encouragement, and cancer screening in families with and without mutations for hereditary nonpolyposis colorectal cancer: A pilot study. Genetics in Medicine, 11, 728-734. https:\/\/dx.doi.org\/10.1097\/GIM.0b013e3181b3f42d","DOI":"10.1097\/GIM.0b013e3181b3f42d"},{"key":"bibr16-1074840718815844","first-page":"102","volume-title":"Family communication about genetics: Theory and practice","author":"Galvin K. M.","year":"2010"},{"key":"bibr17-1074840718815844","doi-asserted-by":"crossref","unstructured":"Granovetter M. (1983). The strength of weak ties: A network theory revisited. Sociological Theory, 1, 201-233. https:\/\/dx.doi.org\/10.2307\/202051","DOI":"10.2307\/202051"},{"key":"bibr18-1074840718815844","doi-asserted-by":"crossref","unstructured":"Griffiths F., Cave J., Boardman F., Ren J., Pawlikowska T., Ball R. Cohen A. (2012). Social networks\u2014The future for health care delivery. Social Science & Medicine, 75, 2233-2241. https:\/\/dx.doi.org\/10.1016\/j.socscimed.2012.08.023","DOI":"10.1016\/j.socscimed.2012.08.023"},{"key":"bibr19-1074840718815844","doi-asserted-by":"crossref","unstructured":"Hoskins L. M., Greene M. H. (2012). Anticipatory loss and early mastectomy for young female\n                      BRCA1\/2\n                      mutation carriers. Qualitative Health Research, 22, 1633-1646. https:\/\/dx.doi.org\/10.1177\/1049732312458182","DOI":"10.1177\/1049732312458182"},{"key":"bibr20-1074840718815844","doi-asserted-by":"crossref","unstructured":"Hoskins L. M., Roy K., Peters J. A., Loud J. T., Greene M. H. (2008). Disclosure of positive\n                      BRCA1\/2\n                      -mutation status in young couples: The journey from uncertainty to bonding through partner support. Families, Systems and Health, 26, 296-316. https:\/\/dx.doi.org\/10.1037\/a0012914","DOI":"10.1037\/a0012914"},{"key":"bibr21-1074840718815844","doi-asserted-by":"crossref","unstructured":"Hoskins L. M., Werner-Lin A., Greene M. H. (2014). In their own words: Treating very young\n                      BRCA1\/2\n                      mutation-positive women with care and caution. PLoS ONE, 9, e87696. https:\/\/dx.doi.org\/10.1371\/journal.pone.0087696","DOI":"10.1371\/journal.pone.0087696"},{"key":"bibr22-1074840718815844","unstructured":"International Family Nursing Association. (2015). IFNA Position Statement on Generalist Competencies for Family Nursing Practice. Retrieved from https:\/\/internationalfamilynursing.org\/wordpress\/wp-content\/uploads\/2015\/07\/GC-Complete-PDF-document-in-color-with-photos-English-language.pdf"},{"key":"bibr23-1074840718815844","unstructured":"International Family Nursing Association. (2017). IFNA Position Statement on Advanced Practice Competencies for Family Nursing. Retrieved from https:\/\/internationalfamilynursing.org\/2017\/05\/19\/advanced-practice-competencies\/"},{"key":"bibr24-1074840718815844","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780195377903.003.0008"},{"key":"bibr25-1074840718815844","doi-asserted-by":"crossref","unstructured":"Koehly L. M. (2017). It\u2019s interpersonal: Family relationships, genetic risk, and caregiving. The Gerontologist, 57, 32-39. https:\/\/dx.doi.org\/10.1093\/geront\/gnw103","DOI":"10.1093\/geront\/gnw103"},{"key":"bibr26-1074840718815844","doi-asserted-by":"crossref","unstructured":"Koehly L. M., Peters J. A., Kenen R., Hoskins L. M., Ersig A. L., Kuhn N. R. Greene M. H. (2009). Characteristics of health information gatherers, disseminators, and blockers within families at risk of hereditary cancer: Implications for family health communication interventions. American Journal of Public Health, 99, 2203-2209. https:\/\/dx.doi.org\/10.2105\/AJPH.2008.154096","DOI":"10.2105\/AJPH.2008.154096"},{"key":"bibr27-1074840718815844","doi-asserted-by":"crossref","unstructured":"Langer S. L., Brown J. D., Syrjala K. L. (2009). Intrapersonal and interpersonal consequences of protective buffering among cancer patients and caregivers. Cancer, 115, 4311-4325. https:\/\/dx.doi.org\/10.1002\/cncr.24586","DOI":"10.1002\/cncr.24586"},{"key":"bibr28-1074840718815844","doi-asserted-by":"crossref","unstructured":"Lewis M. A., McBride C. M., Pollak K. I., Puleo E., Butterfield R. M., Emmons K. M. (2006). Understanding health behavior change among couples: An interdependence and communal coping approach. Social Science & Medicine, 62, 1369-1380. https:\/\/dx.doi.org\/10.1016\/j.socscimed.2005.08.006","DOI":"10.1016\/j.socscimed.2005.08.006"},{"key":"bibr29-1074840718815844","doi-asserted-by":"crossref","unstructured":"Loud J. T., Thi\u00e9baut A. C., Abati A. D., Filie A. C., Nichols K., Danforth D. Greene M. H. (2009). Ductal lavage in women from\n                      BRCA1\/2\n                      families: Is there a future for ductal lavage in women at increased genetic risk of breast cancer? Cancer Epidemiology, Biomarkers & Prevention, 18, 1243-1251. https:\/\/dx.doi.org\/10.1158\/1055-9965.EPI-08-0795","DOI":"10.1158\/1055-9965.EPI-08-0795"},{"key":"bibr30-1074840718815844","doi-asserted-by":"crossref","unstructured":"Lyons R. F., Mickelson K. D., Sullivan M. J., Coyne J. C. (1998). Coping as a communal process. Journal of Social and Personal Relationships, 15, 579-605. https:\/\/dx.doi.org\/10.1177\/0265407598155001","DOI":"10.1177\/0265407598155001"},{"key":"bibr31-1074840718815844","doi-asserted-by":"crossref","unstructured":"McBride C. M., Koehly L. M., Sanderson S. C., Kaphingst K. A. (2010). The behavioral response to personalized genetic information: Will genetic risk profiles motivate individuals and families to choose more healthful behaviors? Annual Review of Public Health, 31, 89-103. https:\/\/dx.doi.org\/10.1146\/annurev.publhealth.012809.103532","DOI":"10.1146\/annurev.publhealth.012809.103532"},{"key":"bibr32-1074840718815844","doi-asserted-by":"crossref","unstructured":"Metcalfe A. (2018). Sharing genetic risk information: Implications for family nurses across the life span. Journal of Family Nursing, 24, 86-105. https:\/\/dx.doi.org\/10.1177\/1074840718755401","DOI":"10.1177\/1074840718755401"},{"key":"bibr33-1074840718815844","unstructured":"National Cancer Institute. (2017). In an era of precision medicine, testing new approaches to breast cancer screening. Retrieved from https:\/\/www.cancer.gov\/about-cancer\/screening\/research\/precision-screening-breast"},{"key":"bibr34-1074840718815844","doi-asserted-by":"crossref","unstructured":"Padamsee T. J., Muraveva A., Yee L. D., Wills C. E., Paskett E. D. (2017). Experiencing the cancer of a loved one influences decision-making for breast cancer prevention. Journal of Health Psychology. https:\/\/doi.org\/10.1177\/1359105317746480","DOI":"10.1177\/1359105317746480"},{"key":"bibr35-1074840718815844","doi-asserted-by":"crossref","unstructured":"Palmquist A. E., Koehly L. M., Peterson S. K., Shegog M., Vernon S. W., Gritz E. R. (2010). \u201cThe cancer bond\u201d: Exploring the formation of cancer risk perception in families with Lynch syndrome. Journal of Genetic Counseling, 19, 473-486. https:\/\/dx.doi.org\/10.1007\/s10897-010-9299-8","DOI":"10.1007\/s10897-010-9299-8"},{"key":"bibr36-1074840718815844","doi-asserted-by":"crossref","unstructured":"Peters J. A., Kenen R., Hoskins L. M., Koehly L. M., Graubard B., Loud J. T., Greene M. H. (2011). Unpacking the blockers: Understanding perceptions and social constraints of health communication in Hereditary Breast Ovarian Cancer (HBOC) susceptibility families. Journal of Genetic Counseling, 20, 450-464. https:\/\/dx.doi.org\/10.1007\/s10897-011-9370-0","DOI":"10.1007\/s10897-011-9370-0"},{"key":"bibr37-1074840718815844","doi-asserted-by":"crossref","unstructured":"Peterson S. K. (2005). The role of the family in genetic testing: Theoretical perspectives, current knowledge, and future directions. Health Education & Behavior, 32, 627-639. https:\/\/dx.doi.org\/10.1177\/1090198105278751","DOI":"10.1177\/1090198105278751"},{"key":"bibr38-1074840718815844","doi-asserted-by":"crossref","unstructured":"Rodriguez V. M., Corona R., Bodurtha J. N., Quillin J. M. (2016). Family ties: The role of family context in family health history communication about cancer. Journal of Health Communication, 21, 346-355. https:\/\/dx.doi.org\/10.1080\/10810730.2015.1080328","DOI":"10.1080\/10810730.2015.1080328"},{"key":"bibr39-1074840718815844","doi-asserted-by":"crossref","unstructured":"Rolland J. S. (2005). Cancer and the family: An integrative model. Cancer, 104(Suppl. 11), 2584-2595. https:\/\/dx.doi.org\/10.1002\/cncr.21489","DOI":"10.1002\/cncr.21489"},{"key":"bibr40-1074840718815844","doi-asserted-by":"crossref","unstructured":"Sandelowski M. (1995). Sample size in qualitative research. Research in Nursing & Health, 18, 179-183. https:\/\/dx.doi.org\/10.1002\/nur.4770180211","DOI":"10.1002\/nur.4770180211"},{"key":"bibr41-1074840718815844","doi-asserted-by":"crossref","unstructured":"Seymour K. C., Addington-Hall J., Lucassen A. M., Foster C. L. (2010). What facilitates or impedes family communication following genetic testing for cancer risk? A systematic review and meta-synthesis of primary qualitative research. Journal of Genetic Counseling, 19, 330-342. https:\/\/dx.doi.org\/10.1007\/s10897-010-9296-y","DOI":"10.1007\/s10897-010-9296-y"},{"key":"bibr42-1074840718815844","doi-asserted-by":"crossref","unstructured":"Sinicrope P. S., Patten C. A., Clark L. P., Brockman T. A., Rock E. E., Frost M. H. Cerhan J. R. (2009). Adult daughters\u2019 reports of breast cancer risk reduction and early detection advice received from their mothers: An exploratory study. Psycho-Oncology, 18, 169-178. https:\/\/dx.doi.org\/10.1002\/pon.1393","DOI":"10.1002\/pon.1393"},{"key":"bibr43-1074840718815844","doi-asserted-by":"crossref","unstructured":"Thorne S., Kirkham S. R., MacDonald-Emes J. (1997). Focus on qualitative methods: Interpretive description: A noncategorical qualitative alternative for developing nursing knowledge. Research in Nursing & Health, 20, 169-177. https:\/\/dx.doi.org\/10.1002\/(SICI)1098-240X(199704)20:2<169:AID-NUR9>3.0.CO;2-I","DOI":"10.1002\/(SICI)1098-240X(199704)20:2<169::AID-NUR9>3.3.CO;2-B"},{"key":"bibr44-1074840718815844","doi-asserted-by":"crossref","unstructured":"Werner-Lin A. (2008). Formal and informal support needs of young women with BRCA mutations. Journal of Psychosocial Oncology, 26, 111-133. https:\/\/dx.doi.org\/10.1080\/07347330802359776","DOI":"10.1080\/07347330802359776"},{"key":"bibr45-1074840718815844","doi-asserted-by":"crossref","unstructured":"Werner-Lin A., Ersig A. L., Mueller R., Young J. L., Hoskins L. M., Desai R., Greene M. H. (2018). Catalysts towards cancer risk management action: A longitudinal study of reproductive-aged women with\n                      BRCA1\/2\n                      mutations. Journal of Psychosocial Oncology. Advance online publication. https:\/\/dx.doi.org\/10.1080\/07347332.2018.1469565","DOI":"10.1080\/07347332.2018.1469565"},{"key":"bibr46-1074840718815844","doi-asserted-by":"crossref","unstructured":"Werner-Lin A., Gardner D. S. (2009). Family illness narratives of inherited cancer risk: Continuity and transformation. Families, Systems and Health, 27, 201-212. http:\/\/dx.doi.org\/10.1037\/a0016983","DOI":"10.1037\/a0016983"},{"key":"bibr47-1074840718815844","doi-asserted-by":"crossref","unstructured":"Werner-Lin A., Zaspel L., Carlson M., Mueller R., Walser S. A., Desai R., Bernhardt B. A. (2018). Gratitude, protective buffering, and cognitive dissonance: How families respond to pediatric whole exome sequencing in the absence of actionable results. American Journal of Medical Genetics Part A, 176, 578-588. https:\/\/dx.doi.org\/10.1002\/ajmg.a.38613","DOI":"10.1002\/ajmg.a.38613"},{"key":"bibr48-1074840718815844","volume-title":"Nurses and families: A guide to family assessment and intervention","author":"Wright L. M.","year":"2013","edition":"6"},{"key":"bibr49-1074840718815844","doi-asserted-by":"crossref","unstructured":"Young A. L., Butow P. N., Vetsch J., Quinn V. F., Patenaude A. F., Tucker K. M., Wakefield C. E. (2017). Family communication, risk perception and cancer knowledge of young adults from\n                      BRCA1\/2\n                      families: A systematic review. Journal of Genetic Counseling, 26, 1179-1196. https:\/\/dx.doi.org\/10.1007\/s10897-017-0125-4","DOI":"10.1007\/s10897-017-0125-4"},{"key":"bibr50-1074840718815844","doi-asserted-by":"crossref","unstructured":"Ziogas A., Horick N. K., Kinney A. Y., Lowery J. T., Domchek S. M., Isaacs C. Plon S. E. (2011). Clinically relevant changes in family history of cancer over time. Journal of the American Medical Association, 306, 172-178. https:\/\/dx.doi.org\/10.1001\/jama.2011.955","DOI":"10.1001\/jama.2011.955"}],"container-title":["Journal of Family Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1074840718815844","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1074840718815844","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1074840718815844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:14:18Z","timestamp":1777500858000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1074840718815844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,12]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1177\/1074840718815844"],"URL":"https:\/\/doi.org\/10.1177\/1074840718815844","relation":{},"ISSN":["1074-8407","1552-549X"],"issn-type":[{"value":"1074-8407","type":"print"},{"value":"1552-549X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,12]]}}}